hypoglossal nerve


Summary: The 12th cranial nerve. The hypoglossal nerve originates in the hypoglossal nucleus of the medulla and supplies motor innervation to all of the muscles of the tongue except the palatoglossus (which is supplied by the vagus). This nerve also contains proprioceptive afferents from the tongue muscles.

Top Publications

  1. Hwang K, Kim S, Kim D. Facial-hypoglossal nerve anastomosis using laser nerve welding. J Craniofac Surg. 2006;17:687-91 pubmed
    ..injected in the epineurium distal to the anastomosis site on the postoperative 6th week and in the normal hypoglossal nerve in the five rats of the control group...
  2. Lefaucheur J, Neves D, Vial C. [Electrophysiological monitoring of cranial motor nerves (V, VII, IX, X, XI, XII)]. Neurochirurgie. 2009;55:136-41 pubmed publisher
    ..nerve (VIIth), glossopharyngeal nerve (IXth), pneumogastric nerve (Xth), spinal accessory nerve (XIth), and hypoglossal nerve (XIIth), in particular during surgical removal of tumors of the cerebellopontine angle or skull base...
  3. Tran A, Prentice D, Chan M. Tophaceous gout of the odontoid process causing glossopharyngeal, vagus, and hypoglossal nerve palsies. Int J Rheum Dis. 2011;14:105-8 pubmed publisher
    ..Specific involvement of the odontoid process is even rarer. We report the first case of gout involving the odontoid process with resultant glossopharyngeal (CN IX), vagus (CN X) and hypoglossal (CN XII) nerve palsies...
  4. Skulsky E, Osman N, Baghdoyan H, Lydic R. Microdialysis delivery of morphine to the hypoglossal nucleus of Wistar rat increases hypoglossal acetylcholine release. Sleep. 2007;30:566-73 pubmed
    ..comprise the first direct measures of ACh release in XII and support the conclusion that morphine depresses hypoglossal nerve activity, in part, by increasing ACh release in XII...
  5. Campero A, Socolovsky M. Facial reanimation by means of the hypoglossal nerve: anatomic comparison of different techniques. Neurosurgery. 2007;61:41-9; discussion 49-50 pubmed
    ..93 +/- 1.41 mm, respectively. The average distance from the bifurcation of the facial nerve to the hypoglossal nerve turn is 31.56 +/- 2.53 mm...
  6. Dong Y, Li J, Zhang F, Li Y. Nociceptive afferents to the premotor neurons that send axons simultaneously to the facial and hypoglossal motoneurons by means of axon collaterals. PLoS ONE. 2011;6:e25615 pubmed publisher
    ..These data indicate that some premotor neurons could integrate the orofacial nociceptive input from the Vc and transfer these signals simultaneously to different brainstem motonuclei by axonal collaterals. ..
  7. Godefroy W, Malessy M, Tromp A, van der Mey A. Intratemporal facial nerve transfer with direct coaptation to the hypoglossal nerve. Otol Neurotol. 2007;28:546-50 pubmed
    To evaluate functional recovery after facial-hypoglossal nerve transfer with direct coaptation of the intratemporal part of the facial nerve. Retrospective study. University-based tertiary referral center...
  8. Terzis J, Tzafetta K. Outcomes of mini-hypoglossal nerve transfer and direct muscle neurotization for restoration of lower lip function in facial palsy. Plast Reconstr Surg. 2009;124:1891-904 pubmed publisher
    ..The authors' unit has reported dynamic strategies for lower lip reanimation and use of 40 percent of the hypoglossal nerve (mini-hypoglossal) in facial reanimation...
  9. Topsakal C, Al Mefty O, Bulsara K, Williford V. Intraoperative monitoring of lower cranial nerves in skull base surgery: technical report and review of 123 monitored cases. Neurosurg Rev. 2008;31:45-53 pubmed
    ..The vagus nerve (n=37), spinal accessory nerve (n=118), and the hypoglossal nerve (n=83) were monitored intraoperatively...

More Information


  1. Islam S, Walton G, Howe D. Aberrant anatomy of the hypoglossal nerve. J Laryngol Otol. 2012;126:538-40 pubmed publisher
    Variant anatomy of the hypoglossal nerve is very rare. We report an unusual intra-operative finding of an aberrant branch of the hypoglossal nerve, encountered during a facial reanimation procedure...
  2. Hajiha M, DuBord M, Liu H, Horner R. Opioid receptor mechanisms at the hypoglossal motor pool and effects on tongue muscle activity in vivo. J Physiol. 2009;587:2677-92 pubmed publisher
    ..The inhibitory effects of mu- and delta-opioid receptors at the HMN also indicate an influence of endogenous enkephalins and endorphins in respiratory motor control. ..
  3. Ramchandren S, Gruis K, Chervin R, Lisabeth L, Concannon M, Wolfe J, et al. Hypoglossal nerve conduction findings in obstructive sleep apnea. Muscle Nerve. 2010;42:257-61 pubmed publisher
    ..We sought to compare hypoglossal nerve conduction studies in patients with and without OSA...
  4. Popratiloff A, Streppel M, Gruart A, Guntinas Lichius O, Angelov D, Stennert E, et al. Hypoglossal and reticular interneurons involved in oro-facial coordination in the rat. J Comp Neurol. 2001;433:364-79 pubmed
    ..Hypoglossal internuclear interneurons projecting to the facial nucleus, as well as those neurons of the parvocellular reticular formation that project to both facial and hypoglossal nuclei, could be involved in oro-facial coordination. ..
  5. Okada M, Itoh Mi M, Haraguchi M, Okajima T, Inoue M, Oishi H, et al. b-series Ganglioside deficiency exhibits no definite changes in the neurogenesis and the sensitivity to Fas-mediated apoptosis but impairs regeneration of the lesioned hypoglossal nerve. J Biol Chem. 2002;277:1633-6 pubmed
  6. Bereiter D, Bereiter D, Hirata H, Hu J. c-fos expression in trigeminal spinal nucleus after electrical stimulation of the hypoglossal nerve in the rat. Somatosens Mot Res. 2000;17:229-37 pubmed
    ..c-fos, was used to determine the distribution of brainstem neurons activated by stimulation of the distal hypoglossal nerve (XIIn) trunk...
  7. Sengupta D, Grevitt M, Mehdian S. Hypoglossal nerve injury as a complication of anterior surgery to the upper cervical spine. Eur Spine J. 1999;8:78-80 pubmed
    Injury to the hypoglossal nerve is a recognised complication after soft tissue surgery in the upper part of the anterior aspect of the neck, e.g. branchial cyst or carotid body tumour excision...
  8. Liu X, Sood S, Liu H, Horner R. Opposing muscarinic and nicotinic modulation of hypoglossal motor output to genioglossus muscle in rats in vivo. J Physiol. 2005;565:965-80 pubmed
    ..The results suggest that acetylcholine has mixed effects at the HMN with muscarinic-mediated GG suppression masking nicotinic excitation. ..
  9. Svensson M, Mattsson P, Aldskogius H. A bromodeoxyuridine labelling study of proliferating cells in the brainstem following hypoglossal nerve transection. J Anat. 1994;185 ( Pt 3):537-42 pubmed
    The proliferative activity in the hypoglossal nucleus following hypoglossal nerve injury has been studied with the 3H-thymidine analogue, bromodeoxyuridine (BrdUrd)...
  10. Adachi T, Robinson D, Miles G, Funk G. Noradrenergic modulation of XII motoneuron inspiratory activity does not involve alpha2-receptor inhibition of the Ih current or presynaptic glutamate release. J Appl Physiol (1985). 2005;98:1297-308 pubmed
  11. Fenik P, Ogawa H, Veasey S. Hypoglossal nerve response to 5-HT3 drugs injected into the XII nucleus and vena cava in the rat. Sleep. 2001;24:871-8 pubmed
    ..These results highlight the importance of understanding serotonergic effects on respiratory drive outside the UAWD motor nuclei as we search for 5-HT drug therapies for OSDB. ..
  12. Vacher C, Dauge M. Morphometric study of the cervical course of the hypoglossal nerve and its application to hypoglossal facial anastomosis. Surg Radiol Anat. 2004;26:86-90 pubmed
    The hypoglossal nerve is used classically in salvage of facial paralyses in the absence of spontaneous recovery...
  13. Kiryu S, Morita N, Ohno K, Maeno H, Kiyama H. Regulation of mRNA expression involved in Ras and PKA signal pathways during rat hypoglossal nerve regeneration. Brain Res Mol Brain Res. 1995;29:147-56 pubmed
    ..The present study may suggest a possibility of regulatory talk between these two major signal transduction pathways. ..
  14. Paniello R, West S, Lee P. Laryngeal reinnervation with the hypoglossal nerve. I. Physiology, histochemistry, electromyography, and retrograde labeling in a canine model. Ann Otol Rhinol Laryngol. 2001;110:532-42 pubmed
    This study was performed to determine whether the hypoglossal nerve (cranial nerve XI [XII]) would serve as a useful donor for laryngeal reinnervation by anastomosis to the recurrent laryngeal nerve (RLN)...
  15. Chow M, Addas B, Sangalang V, Holness R. Cavernous malformation of the hypoglossal nerve: case report and review of the literature. Can J Neurol Sci. 2002;29:191-4 pubmed
    To describe a patient who presented with a hypoglossal nerve palsy caused by a cavernous malformation, review the literature on cavernous malformations associated with cranial nerves and the differential diagnosis of hypoglossal palsy...
  16. Ji J, He B, Dheen S, Tay S. Interactions of chemokines and chemokine receptors mediate the migration of mesenchymal stem cells to the impaired site in the brain after hypoglossal nerve injury. Stem Cells. 2004;22:415-27 pubmed
    ..role of some chemokines and their receptors in the trafficking of rat MSCs (rMSCs) in a rat model of left hypoglossal nerve injury...
  17. Dauvergne C, Pinganaud G, Buisseret P, Buisseret Delmas C, Zerari Mailly F. Reticular premotor neurons projecting to both facial and hypoglossal nuclei receive trigeminal afferents in rats. Neurosci Lett. 2001;311:109-12 pubmed
    ..These neurons were mainly encountered ventral to the trigeminal motor nucleus and dorsal to the VII. Functionally, this region is known to be involved in eye protection mechanisms. ..
  18. Adams H, Verhoff M, Hagemeyer T, Muller K. [Arachnoid cyst with consecutive brain stem atrophy, hypoglossal nerve paresis and tongue atrophy]. Pathologe. 2001;22:266-9 pubmed
    ..This led to palsy of the hypoglossal nerve and partial gliosis of the brainstem with consecutive hemiatrophy of the tongue...
  19. Streppel M, Popratiloff A, Gruart A, Angelov D, Guntinas Lichius O, Delgado Garcia J, et al. [Morphological connections between the Hypoglassal and facial nerve in the brain stem of the rat]. HNO. 2000;48:911-6 pubmed
    ..Moreover, both populations of neurons might be responsible for the excellent postoperative results after hypoglossal-facial anastomosis. ..
  20. Zerari Mailly F, Pinganaud G, Dauvergne C, Buisseret P, Buisseret Delmas C. Trigemino-reticulo-facial and trigemino-reticulo-hypoglossal pathways in the rat. J Comp Neurol. 2001;429:80-93 pubmed
    ..These experiments demonstrate the existence of trigeminal disynaptic influences, via reticular neurons of the pontomedullary reticular formation, in the control of orofacial motor behaviors. ..
  21. Bellingham M, Funk G. Cholinergic modulation of respiratory brain-stem neurons and its function in sleep-wake state determination. Clin Exp Pharmacol Physiol. 2000;27:132-7 pubmed
    ..Cholinergic changes in respiratory modulation of HM recorded in rhythmic brain-stem slices from mice depend on the site of activation of cholinergic receptors. ..
  22. Ciucci M, Schaser A, Russell J. Exercise-induced rescue of tongue function without striatal dopamine sparing in a rat neurotoxin model of Parkinson disease. Behav Brain Res. 2013;252:239-45 pubmed publisher
    ..However, this mechanism is not related to sparing of striatal dopamine content. ..
  23. Taccola G, Secchia L, Ballanyi K. Anoxic persistence of lumbar respiratory bursts and block of lumbar locomotion in newborn rat brainstem spinal cords. J Physiol. 2007;585:507-24 pubmed
  24. Rukhadze I, Kubin L. Mesopontine cholinergic projections to the hypoglossal motor nucleus. Neurosci Lett. 2007;413:121-5 pubmed
    ..The results demonstrate direct mesopontine ACh projections to the Mo12. These projections may contribute to the characteristic of wakefulness and REM sleep increases, as well as REM sleep-related decrements, of 12 motoneuronal activity. ..
  25. Vecchio L, Grace K, Liu H, Harding S, Le A, Horner R. State-dependent vs. central motor effects of ethanol on breathing. J Appl Physiol (1985). 2010;108:387-400 pubmed publisher
  26. Ulu S, Bucak A, Gonul Y, Guzel H, Tekin M. Different navigation of the hypoglossal nerve in the same patient: in the light of the literature. J Craniofac Surg. 2013;24:e393-4 pubmed publisher
    The hypoglossal nerve appears typically between the internal carotid artery and internal jugular vein and down in the lateral groove between these 2 anatomical structures on to the right common carotid artery bifurcation...
  27. Aladdin Y, Siddiqi Z, Khan K, Ahmed S. Hypoglossal-vertebral entrapment syndrome. Neurology. 2008;71:461 pubmed publisher
  28. Montero F, Portillo F, Gonzalez Forero D, Moreno Lopez B. The nitric oxide/cyclic guanosine monophosphate pathway modulates the inspiratory-related activity of hypoglossal motoneurons in the adult rat. Eur J Neurosci. 2008;28:107-16 pubmed publisher
    ..We conclude that NO from afferent fibers anterogradely modulates the inspiratory-related activity of HMNs by a cGMP-dependent mechanism in physiological conditions. ..
  29. Tacik P, Alfieri A, Kornhuber M, Dressler D. Gasperini's syndrome: its neuroanatomical basis now and then. J Hist Neurosci. 2012;21:17-30 pubmed publisher
    ..This resulted in a historical survey of the development of neuroanatomy over the last 300 years. ..
  30. Okamura A, Nakaoka M, Ohbayashi N, Yahara K, Nabika S. Intraoperative cone-beam computed tomography contributes to avoiding hypoglossal nerve palsy during transvenous embolization for dural arteriovenous fistula of the anterior condylar confluence. Interv Neuroradiol. 2016;22:584-9 pubmed publisher
    ..However, some reports call attention to hypoglossal nerve palsy associated with TVE due to coil mass compression of the hypoglossal nerve caused by coil deviation ..
  31. Kecskes G, Herman P, Kania R, Salvan D, El Bakkouri W, Huy P, et al. Lengthening temporalis myoplasty versus hypoglossal-facial nerve coaptation in the surgical rehabilitation of facial palsy: evaluation by medical and nonmedical juries and patient-assessed quality of life. Otol Neurotol. 2009;30:217-22 pubmed publisher
    ..End-to-end coaptation should be restricted to patients with a strong emotional expression or those with a long-standing facial palsy because it provides a strong muscle tone but significant synkinesis. ..
  32. Ferrucci M, Spalloni A, Bartalucci A, Cantafora E, Fulceri F, Nutini M, et al. A systematic study of brainstem motor nuclei in a mouse model of ALS, the effects of lithium. Neurobiol Dis. 2010;37:370-83 pubmed publisher
    ..Moreover, in the hypoglossal nucleus, we found that recurrent collaterals were markedly lost in G93A mice while they were rescued by chronic lithium administration. ..
  33. Jian F, Su C, Chen Z, Wang X, Ling F. Feasibility and limitations of C1 lateral mass screw placement in patients of atlas assimilation. Clin Neurol Neurosurg. 2012;114:590-6 pubmed publisher
    ..Hypoglossal canal also had potential risk of injury during screw placement. In patients of C1A, when C1 lateral mass screw placement is programmed, factors limit its use should be well studied, and CT angiography is essential. ..
  34. Zubrzycka M, Janecka A. Interactions of galanin with endomorphin-2, vasopressin and oxytocin in nociceptive modulation of the trigemino-hypoglossal reflex in rats. Physiol Res. 2008;57:769-76 pubmed
    ..The present results demonstrate that in the orofacial area analgesic activity is modulated by GAL, OT and AVP and that EM-2-induced antinociception involves GAL. ..
  35. Shipchandler T, Seth R, Alam D. Split hypoglossal-facial nerve neurorrhaphy for treatment of the paralyzed face. Am J Otolaryngol. 2011;32:511-6 pubmed publisher
    ..Long-term rest symmetry and potential learned movement can be achieved. This technique may provide a favorable alternative to the traditional method of complete hypoglossal sacrifice or jump grafting. ..
  36. Brandes I, Stettner G, Mörschel M, Kubin L, Dutschmann M. REM sleep-like episodes of motoneuronal depression and respiratory rate increase are triggered by pontine carbachol microinjections in in situ perfused rat brainstem preparation. Exp Physiol. 2011;96:548-55 pubmed publisher
    b>Hypoglossal nerve activity (HNA) controls the position and movements of the tongue...
  37. Nguyen B, Malone B, Sidman J, Barnett Roby B. Excision of sublingual gland as treatment for ranulas in pediatric patients. Int J Pediatr Otorhinolaryngol. 2017;97:154-156 pubmed publisher
    ..5%). One patient reported lateral tongue numbness post-operatively, and one patient had a hypoglossal nerve injury, with tongue deviation upon exam...
  38. Luna Ortiz K, Villavicencio Valencia V, Carmona Luna T, Cano Valdez A, Herrera Gomez A. Carotid body tumour resection with LigaSure device. Acta Otorrinolaringol Esp. 2010;61:6-11 pubmed publisher
    ..Nerve injury continues to be an important postoperative complication, which may result in a reduction in the quality of life for the patient. The rates of nerve injury as a result of surgery were unchanged. ..
  39. Stepien A, Durka Kesy M, Warczynska A. [Compression neuropathy of cranial nerves in the course of Takayasu arteritis]. Neurol Neurochir Pol. 2007;41:557-61 pubmed
    ..The symptoms had sudden onset. Neurological examination revealed isolated trigeminal, glossopharyngeal and hypoglossal nerve dysfunction on the right side without other neurological symptoms...
  40. Horner R. Respiratory motor activity: influence of neuromodulators and implications for sleep disordered breathing. Can J Physiol Pharmacol. 2007;85:155-65 pubmed
  41. Berger A, Sebe J. Developmental effects of ketamine on inspiratory hypoglossal nerve activity studied in vivo and in vitro. Respir Physiol Neurobiol. 2007;157:206-14 pubmed
    The effects of the anesthetic ketamine on properties of inspiratory bursts (I-bursts) in mouse hypoglossal nerve activity were studied in vivo and in vitro...
  42. van Brederode J, Berger A. GAD67-GFP+ neurons in the Nucleus of Roller. II. Subthreshold and firing resonance properties. J Neurophysiol. 2011;105:249-78 pubmed publisher
    ..This heterogeneity of resonance properties might serve to selectively activate subgroups of interneurons. ..
  43. Bartman M, Wilkerson J, Johnson S. 5-HT3 receptor-dependent modulation of respiratory burst frequency, regularity, and episodicity in isolated adult turtle brainstems. Respir Physiol Neurobiol. 2010;172:42-52 pubmed publisher
    ..We conclude that endogenous 5-HT(3) receptor activation regulates respiratory frequency, regularity, and episodicity in turtles and may induce a form of respiratory plasticity with the long-lasting changes in respiratory regularity. ..
  44. Shcherbatyy V, Perkins J, Liu Z. Internal kinematics of the tongue following volume reduction. Anat Rec (Hoboken). 2008;291:886-93 pubmed publisher
    ..This compensatory effect, however, diminishes during stimulation of the hypoglossal nerve and individual tongue muscles.
  45. Lee K, Fuller D, Hwang J. Pulmonary C-fiber activation attenuates respiratory-related tongue movements. J Appl Physiol (1985). 2012;113:1369-76 pubmed publisher
    ..The diminished tongue force and delay in the onset of tongue movements following pulmonary C-fiber activation are potentially unfavorable for upper airway patency. ..
  46. Taylor B, Brundage C, McLane L. Chronic nicotine and ethanol exposure both disrupt central ventilatory responses to hypoxia in bullfrog tadpoles. Respir Physiol Neurobiol. 2013;187:234-43 pubmed publisher
  47. Mørch C, Hu J, Arendt Nielsen L, Sessle B. Convergence of cutaneous, musculoskeletal, dural and visceral afferents onto nociceptive neurons in the first cervical dorsal horn. Eur J Neurosci. 2007;26:142-54 pubmed
    ..was applied to facial, neck, shoulder and forepaw skin, cornea (COR), dura, second cervical (C2) nerve, hypoglossal nerve, temporomandibular joint, masseter (MAS) muscle and superior laryngeal nerve...
  48. Nasse J, Terman D, Venugopal S, Hermann G, Rogers R, Travers J. Local circuit input to the medullary reticular formation from the rostral nucleus of the solitary tract. Am J Physiol Regul Integr Comp Physiol. 2008;295:R1391-408 pubmed publisher
    ..We present an updated dynamic model that summarizes the complex synaptic interface between the rNST and the IRt and demonstrates how inhibition could contribute to the transition from ingestion to rejection. ..
  49. Hontanilla B, Vila A. Comparison of hemihypoglossal-facial nerve transposition with a cross-facial nerve graft and muscle transplant for the rehabilitation of facial paralysis using the facial clima method. J Plast Surg Hand Surg. 2012;46:25-31 pubmed publisher
    ..However, the transposition group had correct symmetry at rest but more asymmetry of CCV and CD when smiling. ..
  50. Kriegel A, Liu Y, Liu P, Baker M, Hodges M, Hua X, et al. Characteristics of microRNAs enriched in specific cell types and primary tissue types in solid organs. Physiol Genomics. 2013;45:1144-56 pubmed publisher
    ..These data indicate that the role of miRNAs in determining characteristics of primary tissue types may be different than their role in regulating cell type-specific functions in solid organs. ..
  51. Rohlfing M, Waltonen J. Atypical location of the hypoglossal nerve and its implications: a case report. Surg Radiol Anat. 2016;38:863-5 pubmed publisher
    ..Anatomic variants of the hypoglossal nerve are rare, and their incidences are unknown...
  52. Soyal O, Turan S, Durak P, Erdemli O. Transient palsy of peripheral cranial nerves following open heart surgery. Singapore Med J. 2006;47:422-4 pubmed
  53. van Brederode J, Berger A. Spike-firing resonance in hypoglossal motoneurons. J Neurophysiol. 2008;99:2916-28 pubmed publisher